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Surgery for Desperados

In the 1920s, the notorious American bandit Roy Gardner riveted the public’s attention with his “hair-raising escapes from the law.”[1] He was arrested three times for mail robbery, and three times he made a successful run for it, including once from the federal penitentiary on McNeal Island in Washington State, when he fled in a hail of bullets and managed to swim to a nearby island, despite his injuries.[2]

Two months later, this “spectacular desperado” (as the newspapers called him), was recaptured, and true to form he tried again to evade incarceration. But this time he took the legal route. Gardner claimed that a blow to the head he had suffered years before in a mining accident was the source of the uncontrollable criminal tendency that compelled him to rob trains and escape from jail. In the mid 1920s, he lobbied prison authorities relentlessly for permission to undergo a surgical procedure to remove the depressed bone which was supposedly pressing on his brain and making him a criminal.[3] Gardner claimed he knew that “cutting into the brain is a business that often means death,” but he desperately wanted to become an “honest man” for his wife and child. One unlikely supporter of Gardner’s campaign was the deputy sheriff who had captured him and who now made a public appeal for a surgical intervention. “The man’s mind is wrong, or he wouldn’t have taken the desperate, foolish chances he has,” the deputy sheriff reasoned. “I believe the surgeons can change him into an honest man, and they ought to be allowed to try.”[4]

The belief that surgery on the skull and brain could cure afflictions of the mind may appear out of place in the 1920s, coming as it did many years before the Portuguese neurologist Egas Moniz developed a psychosurgical technique in which the connections between the prefrontal cortex and the rest of the brain were severed in an attempt to alleviate symptoms of mental illness (the prefrontal leucotomy or lobotomy, first performed in 1935).

In fact, ‘escaping’ prison by way of surgery on the skull or brain was far from unprecedented in the decades before the introduction of lobotomy. If Gardner didn’t learn about the procedure from a doctor, he might very well have been inspired by the many stories similar to his own which appeared in the newspapers. For instance, a decade and a half earlier, a notorious check forger underwent a much talked about skull operation that drew commentary even from a former chief of the United States Secret Service.[5] The Governor of New York pardoned Edward Grimmell because “[m]any scientific men are interested in seeing whether his criminal tendencies have disappeared, which can only be determined by his conduct when at large […] I am willing that the Parole Board should permit the experiment to be tried in this case […].”[6]

The experiment did in fact fail – Grimmell reoffended and landed in prison again – but the hope that the scalpel – or, more accurately, the trephine[7] – could reform criminals proved to be very resilient. Although no statistics were ever compiled, based on medical reports and newspaper accounts, I estimate that from the late nineteenth century to the late 1920s, hundreds of men, women, and children in the United States underwent similar operations. Most often, these consisted of ‘decompressive’ procedures in which a ‘button of bone’ was permanently removed from the skull over the site of an old injury to alleviate the supposed pressure on the brain that was thought to cause criminal behavior. In other cases, the surgeons would also incise the membranes that cover the brain or the brain matter itself if a scar warranted it. For instance, the fashionable Los Angeles surgeon Cecil Reynolds, who also happened to be Charlie Chaplin’s personal physician, opened the skull of a man who had been convicted of various crimes including forgery and found a scar on the dura and an “opaque thickening” on the arachnoid membrane, which he incised.[8]

This procedure was not performed or endorsed – though neither was it denounced – by the small number of elite surgeons, such as Harvey Cushing and Ernest Sachs, who were laying the foundations of the new specialty of brain surgery at the beginning of the 20th century. Instead, the doctors who were performing these surgeries were quite diverse practitioners: ordinary surgeons working in county hospitals, prison surgeons, various eclectics and homeopaths. This motley group included doctors like E. H. Pratt, a homeopath from Evanston and a proponent of ‘orificial surgery.’[9] Apart from circumcision and other operations on bodily orifices, Pratt also attempted to trephine the skull of those with criminal tendencies. His most famous case appears to have been that of Winston Salisbury, a writer and Kansas prison convict who had enjoyed a long career as a forger. Claiming that part of the bone was pressing upon a nerve and irritated the brain, Pratt removed a piece of Salisbury’s skull.[10]

Many of the patients survived only to face imprisonment another day – the newspapers were full of stories of these surgeries failing to reform offenders. But of course some did not survive at all. In 1924, Antone W. Wroblewskie, a Detroit war veteran who was deemed to suffer from “criminal tendencies resulting from shell shock,” died in California as a result of his surgery.[11] It is impossible to say how many of the individuals who were subjected to the procedure died. In comparison to the numerous optimistic accounts of instant recoveries from criminal tendencies that the newspapers printed only to invalidate in future stories, there were very few reports of deaths. Nevertheless, given the risks of surgery at the beginning of the 20th century, even in cases in which the brain matter itself was not touched, it is likely that a significant number of these patients succumbed to infection, blood loss, or complications from anesthesia.

The application of this surgical procedure and its enduring popularity even in the face of constant failure is likely due to a mixture of factors. The alliance of the medical and the legal profession in the common belief that “reformation, rather than punishment, should be the aim of our courts of justice,”[12] as one newspaper put it in its defense of the procedure, was certainly such a factor. Progressive-era optimism about using science to fix social problems was probably another. It is not surprising that some of these surgeons were deeply involved in various progressive causes. At least one of them was a notorious eugenicist.[13] Equally significant for the spread of this procedure was a radical interventionist ethos and a therapeutic optimism among many turn-of-the-century American surgeons who were applying new surgical techniques to all sorts of apparent maladies of the brain, from epilepsy to microcephaly to ‘feeblemindedness.’[14]

The procedure faded quietly and ceased to be performed in the late 1920s. But surely one of its legacies was the mixture of optimism and nonchalance with which the American public received the arrival of lobotomy in the late 1930s. The public had been reading for years about the enthusiastic endorsement that some doctors gave to the idea that surgery on the heads of people with mental and behavioral problems could lead to dramatic positive results.

From an article arguing for the utility of surgery on the heads of criminals. Bowers, Edwin F. “For Judge or Surgeon?” New-York Tribune, March 30 1913, SM5.

As for Roy Gardner – despite his and his wife’s desperate pleas, prison officials never did allow him to undergo the procedure. In an ironic twist that also underscores the visibility of these surgeries, on October 4, 1924 the front page of The LA Times printed side by side two similar stories with divergent endings: an exclusive dispatch from Kansas informed readers that Roy Gardner was not “to undergo an operation to relieve brain pressure”[15] while in a nearby column, the thief Frank Mayerle was reported to have entered the hospital for a brain operation he had “begged” to have and which Cecil Reynolds was only too happy to perform.[16]

Delia Gavrus is an assistant professor of the history of science at the University of Winnipeg in Canada. She is interested in and has published on the history of neurosurgery, the history of the mind and brain sciences, and the history of anesthesia.

[13] The surgeon was Harry J. Haiselden. See Martin S. Pernick, The Black Stork: Eugenics and the Death of “Defective” Babies in American Medicine and Motion Pictures since 1915 (New York: Oxford University Press, 1996), 84.